Menstrual Conditions/Irregularities - Oligomenorrhea

Oligomenorrhea is an irregular menstruation and defined as a condition of infrequent period or a woman menstrual period does not occur at a interval of greater than 35 days.

Symptoms

1. Menstrual bleeding
Menstrual bleeding for women with irregular menstruation is last more tham 7 days.

2. Length of period
Woman menstrual period does not occur at a interval of greater than 35 days

3. Menstruation
Women with oligomenorrhea may be experience very light menstruation with with only four to nine periods in a year.

4. Infertility
Women who are experience irregular menstruation are st higher risk of infertility. According to the article of "Irregular Periods and Getting Pregnant" posted at WebMD, Reviewed by Mikio A. Nihira, MD. the author stated that irregular or abnormal ovulation and menstruation accounts for 30% to 40% of all cases of infertility.

5. Irregular menstrual periods with unpredictable flow
It is a result of hormone imbalance. It can happen to women in the perimenopause as well as 2 years after puberty.

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Causes
1. Perimenopause

As a woman approaches the perimenopause stage, menstrual cycle is disturbed due to lower production of sex hormones as a result of irregular response of ovaries to the higher amount FSH produced by pituitary gland.

2. Benign tumor

Adenomas grows at the anterior pituitary gland can affect the function of the gland in secretion of either FSH or LH that can lead to loss of normal menstrual cycles including oligomenorrhea.

3. Certain diseases
a. Hyperthyroidist can cause Oligomenorrhea as a result of over production of thyroid hormone, leading to lightening less often of menstrual flow.
b. Polycystic ovary syndrome (PCOS)
According to the article of Oligomenorrhea posted at the free dictionary by Farlex, the author wrote that Women with PCOS show menstrual irregularities that range from oligomenorrhea and amenorrhea on the one hand to very heavy, irregular periods on the other. The condition affects about 6% of premenopausal women and is related to excess androgen production.

Due to to excess androgen production.
c. Graves disease

Graves disease is an autoimmune disease with overactive the thyroid gland causing production an excessive amount of thyroid hormones, that leads to oligomenorrhea.

4. Intensive exercise

Intensive exercise can affect the women reproductive physiology, that can lead to irregular menstruation including Oligomenorrhea. In study of Reproductive system function in women cross-country runners." by Wakat DK, Sweeney KA, Rogol AD., researchers found that Evaluation of seven runners from one school who qualified for the national meet (1 amenorrheic, 5 oligomenorrheic, and 1 normal) revealed that the basal estrogen, progesterone, prolactin, and thyroid hormone levels were normal and that there were normal luteinizing hormone and follicle-stimulating hormone responses to synthetic gonadotropin-releasing hormone (GnRH). These data are consistent with an alteration of hypothalamic-pituitary-ovarian function above the level of the pituitary.

6. Breast feeding
Breast feeding can increase the risk of oligomenorrhea, due to delay of ovulation as a result of hormonal change.

7. Eating disorders
Eating disorder that can affect your monthly cycle as a result of irregular menstruation. According to the article of "Eating disorders may disrupt menstruation" By Anne Harding, posted in Reuters, the author wrote that any type of eating disorder can boost a woman's likelihood of having irregular menstrual periods, a new study confirms in a survey of 1,705 women participating in a genetic study who met strict diagnostic criteria for eating disorders, Bulik and her team found menstrual irregularities including absence of periods, skipping periods, and very light periods among women with every subtype of eating disorder, including bulimia nervosa.

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Diagnosis
After recording the family history and the time, frequency, length, and quantity of bleeding and physical exam, including pelvic exam and pap smear to rule out certain physical causes of Oligomenorrhea.
1. Blood test
The aim of the test is to rule out the abnormal levels (too high or too low) of thyroid hormone cause of Oligomenorrhea.

2. Ultrasound
Ultrasound allows your doctor to visualize and assess any abnormality and surrounding area of the pelvic with image taken from the test to rule out other cause of diseases.

3. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of any abnormality and surrounding areas.

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Preventions
A. How to prevent in common sense approaches
1. Reduce stress by meditation or yoga
Meditation and yoga can help to keep breathing slow and controlled and to relax and energized the body, thus reducing the stress.

2. Avoid intensive exercise

Intensive exercise can reduce estrogen levels, which can lead irregular menstrual cycle including Oligomenorrhea

3. Nutrient deficiency
unhealthy diet can cause deficiency of vitamins and minerals, including vitamin B complex and magnesium , leading to Oligomenorrhea.

4. Weight loss

Weight loss too quickly increases the risk of hormonal imbalance that can lead to Oligomenorrhea

5. Moderate drinking
According to the answer to the question of Does alcohol affect menstruation?, Chosen by AskerAppolnia_76 stated that YES it does... in a couple of different ways.First, it inhibits the secretion of the ADH, or anti-diuretic hormone from the pituitary gland in the brain... that's why we pee so much when we drink. You are essentially getting dehydrated, so the blood thickens and your menstrual flow will slow down until you re-hydrate yourself. Second, when you drink hard core, like lots of hard liquor or go on a bender for a few days, you can have extra periods or have skipped or late periods too. the reason for this is it messes up your metabolism and your hormones.

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B. Diet
1. Soy Products
Soy products contain high amount of phytochemicals, that can help to balance the body hormones, thus reducing the risk of Oligomenorrhea

2. Fruits and vegetables
Fruits and vegetables contain high amounts of vitamins, minerals, dietary fiber and plenty of antioxidants, that can provide the necessary nutrient to the body and reduce the risk of nutrient deficiency cause of Oligomenorrhea.

3. Flaxseed
Flaxseed not only contains high amount of essential fatty acids which are necessary for heart and reproductive health but also is an extraordinary source of the phytoestrogen lignans, containing 75 to 800 times as much as other plant sources, helped to reduce the risk of the diseases.

4. Beans
Due to high amount of fiber, bean can help to slow the absorption of glucose in the bloodstream, thus reducing the risk of high blood sugar for some menopause with disease of diabetes.Beans are also high sources of vitamin and mineral,such as calcium, folic acid and vitamin B-6. And they also contain some sources of phytoestrogen.

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C. Nutritional supplements

1. Iron
Iron is essential for women suffering from menorrhagia. Since excessive bleeding causes the loss of iron causing iron deficiency, without enough iron our body cannot reproduce red blood cells to replace those lost in bleeding resulting in symptoms of paller, weakness, fatigue as well as increasing the risk of inflammation.

2. Vitamin B complex
Vitamin B complex is a liver tonic vitamin. It helps the liver to convert the bad estrogen, xanooestrogen into weaker and less dangerous forms and converts omega 6 oils into a form that can be used by the body to produce the good type prostaglandins instead of dinoprostone resulting in reduced menstrual cramps and pain.

3. Cod liver oil
Cod liver oil contains high amounts of omega 3 fatty acids that control heavy bleeding during periods. Since red meat and dairy products contain arachidonic acid without balancing intake of omega 3 fatty acid, this causes the over production of dinoprostone leading to increased blood flow, and reducing blood-clotting ability.

4. Zinc
Besides having an important role in treating enlarged prostate in men's health, this mineral is vital for the healthy functioning of the reproductive system in women as well as maintaining hormone balancing.

5. Flavonoid
Flavonoid is a powerful antioxidant activity. It helps to protect small blood vessels from damage resulting in protecting against the blood loss of menorrhagia during menstruation.

6.Vitamin A
Vitamin A is an antioxidant. It works together with iron and copper to help enhance the production of red blood cells. Vitamin A deficiency has been found in women with menorrhagia.

7. Vitamin C
Besides being an antioxidant that helps our body to fight against free radicals from building up and the digestive system's metabolism to reduce menstrual pain.

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Treatments
A. In conventional medicine
A.1. Hormone treatments
1. Contraceptive pill
a. Low-dose combination birth control pills which contains low-dose synthetic forms of the hormones estrogen and progesterone may be use to treat amenorrhea by controlling the menstrual cycle or bring the period back to mormal.
b. Risks and side effects
b.1. Growth of fibroids
Growth of fibroid is caused high level of estrogen and progesterone. The intake of the pill increase the level of both hormones resulting in increase the risk of growth of fibroid.
b.2. Recurrent of menstrual symptoms
Some women stop taking the pill may see all the menstrual symptoms coming back.
b3. Blood clots
Estrogen in the pill may cause blood clots in the small vessels in the leg and the lung.
b.4. Stroke and heart diseases
Study shows that women who have higher natural estrogen levels may have a higher risk of stroke and heart diseases.
b.5. Depression and mood swing
At the beginning, it may cause abnormal fluctuations in estrogen and progesterone elevate both physical and psychological stress, eventually resulting in both depression and mood swing
b.6. Bleeding and spotting
Bleeding and spotting is normal for the first six months for women who begin with any oral contraceptive combination pill treatment.
b.7. Lost interest in sex
Some women may experience lower sexual desire
b.8. Nutritional deficiency
Oral contraceptive pill causes vitamin and mineral imbalances or deficiencies.
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2. Progesterone only pill
Norethisterone a progestogen and has been used used treat premenstrual syndrome, painful periods, abnormal heavy bleeding, irregular periods. In a study of A comparative study of danazol and norethisterone in dysfunctional uterine bleeding presenting as menorrhagia M. Bonduelle, J.J. Walker and A.A. Caldert, researcher found that Since this study was undertaken, a report of
objective measurement of blood loss in small groups of patients9 casts further doubt on the
efficacy ofnorethisterone, although it confirms that of danazol. Since norethisterone is very widely used, a detailed assessment of its efficacy and safety in comparison to danazol is overdue. Should such a study confirm the findings discussed here then danazol could usefully be employed as first line therapy in the management of dysfunctional uterine bleeding presenting as menorrhagia.

B. Herbs
1. Black Cohosh
Black cohosh beside has been used as an emmenagogue to contracts the uterus and initiate menstruation, it also enhances hormone balancing.

2. Chaste tree berry
Chaste tree berry is considered as a queen herb in herbal medicine to regulate the women menstrual cycle by balancing the estrogen and progesterone produced by the ovaries throughout the menstrual cycle.

3. Raspberry leaf
Red Raspberry leaf, a pale-green leaf produced by the raspberry plant has been used in herbal medicine because of its rich content in vitamins, minerals, and tannins and as an aid in delivery. Herbalists suggested that red raspberry leaf enhances the lining of uterus and promotes female reproductive system, including Oligomenorrhea.

4. Cat's claw
Cat's claw is a woody vine found in the tropical jungles of South and Central America> The herb has been used traditionally to treat gastrointestinal ailments, Crohn's disease, gastric ulcers tumors, and women's hormone imbalances.

5. Turmeric
Turmeric is a rhizomatous herbaceous perennial plant of the ginger family and has been use as an antiseptic agent for cuts, burns and bruises as well as an aid digestion and liver function, relieve arthritis pain, and regulate menstruation, in traditional medicine.

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C. Traditional Chinese medicine
1. Angelica root
Chinese Angelica is a sturdy perennial plant that is native to China and Japan. It has been used for over 5000 years in traditional Chinese medicine in treating an overall tonic for the reproductive system as well as balancing hormones and it is also used to relieve the discomforts of premenstrual syndrome, dysmenorrhea, irregular menstruation. oligomenorrhea and amenorrhagia. It is well known as female ginseng.

2. Radix Notoginseng
Also known as tian san qi or tien chi ginseng. It has been used in China for centuries in treating excessive bleeding in irregular menstruation. It is widely used in Asia for angina to help lower cholesterol and triglycerides, and to expand coronary arteries in order to promote blood circulation and prevent blood clots thereby helping to control excessive menstrual bleeding or menorrhagia. It also is a powerful antioxidant that helps to reduce inflammation thus reducing pain caused by menstruation disorders.

3. Licorice
Licorice has been used in traditional Chinese medicine to detoxify and to enhance or balance the effects of other herbs in herbal formula as well as promote estrogenic activity. In a study of "Estrogen-like activity of licorice root constituents: glabridin and glabrene, in vascular tissues in vitro and in vivo". by Somjen D, Knoll E, Vaya J, Stern N, Tamir S., researchers concluded that glb behaved differently than E2 or gla, but similarly to raloxifene, being a partial agonist/antagonist of E2. Glabridin, on the other hand, demonstrated only estrogenic activity. Therefore, we suggest the use of glb with or without E2 as a new agent for modulation of vascular injury and atherogenesis for the prevention of cardiovascular diseases in post-menopausal women.

4. Motherwort
Motherwort is a herbaceous perennial plant in the mint family, It has been used in traditional Chinese medicine in tonifying the uterus and preventing the uterus against infection. Leonurine, a compound in the herb has an effect in promoting uterine contractions. As an emmenagogue, it enhance blood flow.

5. Skullcap
Skullcap is a genus of flowering plants in the mint family, Lamiaceae. It has been used in traditional Chinese medicine to tonify the heart, treat insomnia and enhance immune system. It is said that a infusion of the plant can be used to promote menstruation. According to the article Skullcap - Botanical and Common Names posted in Innvista, the author indicated that An infusion of the fresh aerial parts (if possible) is used to soothe nervous exhaustion, excitability, overanxiety, and premenstrual tension.

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